Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 0935 | KS |
NPI | 1225011380 |
---|---|
Provider Name | Paul Lovejoy Kurtzweil |
First Address | Wichita, KS 67207-5076 |
Second Address | Wichita, KS 67207-5076 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2005 |
Last Update Date | 17/08/2021 |